title: Patient and provider perspectives on methicillin-resistant Staphylococcus aureus: a qualitative assessment of knowledge, beliefs, and behavior.
abstract: BACKGROUND
  Methicillin-resistant Staphylococcus aureus (MRSA) is a frequent cause of healthcare-associated infection. Individuals with spinal cord injuries and disorders (SCI/D) are at high risk of MRSA colonization and infection. The Department of Veterans Affairs (VA) released guidelines to prevent the spread of MRSA in Veterans with SCI/D; however, available patient educational materials did not address the unique issues for this population.
  
  
  OBJECTIVE
  To assess perceptions of SCI/D providers and Veterans with SCI/D regarding MRSA and their educational needs about MRSA prevention, with an ultimate goal of developing patient educational materials that address the issues unique to SCI/D.
  
  
  METHODS
  Purposive samples of SCI/D providers (six groups) and Veterans with SCI/D (one group) at two VA facilities participated in 60-90-minute focus group sessions. Qualitative data were analyzed using latent content and constant comparative techniques to identify focal themes.
  
  
  METHODS
  Thirty-three providers (physicians and nurses working in inpatient, outpatient, and homecare settings) and eight Veterans participated.
  
  
  RESULTS
  Three overarching themes emerged from the analysis: knowledge about MRSA, hand hygiene, and barriers to educating Veterans with SCI/D.
  
  
  CONCLUSIONS
  SCI/D providers and Veterans with SCI/D identified gaps in general MRSA knowledge, gaps in knowledge of good hand hygiene practices and of required frequency of hand hygiene, and barriers to educating Veterans with SCI/D during inpatient stays. Future educational materials and strategies should address these gaps.
authors.affiliation: Edward Hines Jr VA Hospital, Hines, IL, USA. Jennifer.Hill@va.gov
authors.forename: Jennifer N
authors.initials: JN
authors.lastname: Hill
authors.forename: Charlesnika T
authors.initials: CT
authors.lastname: Evans
authors.forename: Kenzie A
authors.initials: KA
authors.lastname: Cameron
authors.forename: Thea J
authors.initials: TJ
authors.lastname: Rogers
authors.forename: Kathleen
authors.initials: K
authors.lastname: Risa
authors.forename: Susan
authors.initials: S
authors.lastname: Kellie
authors.forename: Michael S A
authors.initials: MS
authors.lastname: Richardson
authors.forename: Vicki
authors.initials: V
authors.lastname: Anderson
authors.forename: Barry
authors.initials: B
authors.lastname: Goldstein
authors.forename: Marylou
authors.initials: M
authors.lastname: Guihan
mesh_terms: D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D013118:Spinal Cord Diseases; D013119:Spinal Cord Injuries; D013203:Staphylococcal Infections; D014728:Veterans